Influence of clinical pathways used the hospitals of Traditional Chinese Medicine on patients hospitalized with stroke: a systematic review and Meta-analysis

Abstract Objective To evaluate the influence of clinical pathways in the hospitals using the Traditional Chinese Medicine in treatment of stroke in terms of postoperative complications, length of stay (LOS), costs incurred during hospitalization, compared with standard medical care. Methods Medline, Embase, China National Knowledge Infrastructure (CNKI) platforms, Wanfang databases and the Cochrane Central Register of Controlled Trials were searched. The search was performed up to August 2014. Each study was assessed independently by two reviewers. The assessment of methodological quality of the included studies was based on the Methodological index for non-randomized studies standard. Meta-analyses were performed using RevMan software, version 5.0. Results Six studies met the study inclusion criteria and were included in the Meta-analysis for a total sample of 710 patients. The aggregate overall results showed that shorter length of stay in the clinical pathway group was observed during hospital stay was associated with the use of the clinical pathways. No significant differences were found in other effects. Conclusion Regardless the possible limitations, our findings show that clinical pathways can significantly reduce LOS. Although there is no clear evidence that clinical pathways can reduce hospital costs, but the cost of hospitalization path group for each included study were lower than the control group.